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Anticoagulant use before COVID-19 diagnosis prevent COVID-19 associated acute venous thromboembolism or not:A systematic review and meta-analysis

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World Journal of Methodology 2024年第3期14卷 141-162页

作者： Kinza Iqbal Akshat Banga Taha Bin Arif Sawai Singh Rathore abhishek bhurwal Syeda Kisa Batool Naqvi Muhammad Mehdi Pankaj Kumar Mitali Madhu Salklan Ayman Iqbal Jawad Ahmed Nikhil Sharma Amos Lal Rahul Kashyap Vikas Bansal Juan Pablo Domecq Department of Internal Medicine Dow Medical CollegeKarachi 74200Pakistan Department of Internal Medicine Sawai Man Singh Medical CollegeJaipur 302004India Department of Internal Medicine Dr.Sampurnanand Medical CollegeJodhpur 342003RajasthanIndia Department of Gastroenterology and Hepatology Rutgers Robert Wood Johnson School of MedicineNew BrunswickNJ 08901United States Department of Internal Medicine Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical SciencesRohtak 124001HaryanaIndia Department of Nephrology and Hypertension Mayo ClinicRochesterMN 55905United States Department of Medicine Division of Pulmonary and Critical Care MedicineMayo ClinicRochesterMN 55905United States Department of Research Wellspan HealthYorkPA 17403United States

BACKGROUND Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019(COVID-19)*** is conflicting evidence on the effects of chronic anticoagulation on mortality and severity of COVID-19 *** To summarize the body of evidence on the effects of pre-hospital anticoagulation on outcomes in COVID-19 *** A Literature search was performed on LitCovid PubMed,WHO,and Scopus databases from inception(December 2019)till June 2023 for original studies reporting an association between prior use of anticoagulants and patient outcomes in adults with *** primary outcome was the risk of thromboembolic events in COVID-19 patients taking *** outcomes included COVID-19 disease severity,in terms of intensive care unit admission or invasive mechanical ventilation/intubation requirement in patients hospitalized with COVID-19 infection,and *** random effects models were used to calculate crude and adjusted odds ratios(aORs)with 95%confidence intervals(95%CIs).RESULTS Forty-six observational studies met our inclusion *** unadjusted analysis found no association between prior anticoagulation and thromboembolic event risk[n=43851,9 studies,odds ratio(OR)=0.67(0.22,2.07);P=0.49;I2=95%].The association between prior anticoagulation and disease severity was non-significant[n=186782;22 studies,OR=1.08(0.78,1.49);P=0.64;I2=89%].However,pre-hospital anticoagulation significantly increased all-cause mortality risk[n=207292;35 studies,OR=1.72(1.37,2.17);P<0.00001;I2=93%].Pooling adjusted estimates revealed a statistically non-significant association between pre-hospital anticoagulation and thromboembolic event risk[aOR=0.87(0.42,1.80);P=0.71],mortality[aOR=0.94(0.84,1.05);P=0.31],and disease severity[aOR=0.96(0.72,1.26);P=0.76].CONCLUSION Prehospital anticoagulation was not significantly associated with reduced risk of thromboembolic events,improved survival,and lower disease seve

关键词： Prior anticoagulation COVID-19 Prehospital anticoagulation Chronic anticoagulation Mortality Severity Thromboembolic events

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COVID-19 status quo:Emphasis on gastrointestinal and liver manifestations

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World Journal of Gastroenterology 2021年第46期27卷 7969-7981页

作者： abhishek bhurwal Carlos D Minacapelli Evan Orosz Kapil Gupta Christopher Tait Ishita Dalal Clark Zhang Eric Zhao Vinod K Rustgi Department of Medicine Division of Gastroenterology and HepatologyRutgers Robert Wood Johnson Medical SchoolNew BrunswickNJ 08901United States Center for Liver Diseases and Masses Rutgers Robert Wood Johnson School of MedicineNew BrunswickNJ 08901United States Department of Internal Medicine Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNJ 08901United States

The coronavirus disease 2019(COVID-19)has caused one of the worst public health crises in modern *** though severe acute respiratory syndrome coronavirus 2 primarily affects the respiratory tract,gastrointestinal manifestations are well described in *** review will discuss the epidemiology,virology,manifestations,immunosuppressant states,and lessons learned from ***:At the time of writing,COVID-19 had infected more than 111 million people and caused over 2.5 million deaths *** medical comorbidities including obesity,pre-existing liver condition and the use of proton pump inhibitor have been described as risk factor for severe ***-19 most frequently causes diarrhea(12.4%),nausea/vomiting(9%)and elevation in liver enzymes(15%-20%).The current data does not suggest that patients on immunomodulators have a significantly increased risk of mortality from *** current guidelines from American Gastroenterological Association and American Association for the Study of Liver Diseases do not recommend pre-emptive changes in patients on immunosuppression if the patients have not been infected with *** and relevance:The COVID-19 pandemic has prompted a change in structure and shape of gastroenterology departmental *** should be performed only when necessary and with strict protective *** consultations in the form of telehealth services and home drug deliveries have revolutionized the field.

关键词： COVID-19 Status quo Epidemiology Virology Gastrointestinal manifestations Liver manifestations Immunosuppressed states

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Acute kidney injury and hepatorenal syndrome in cirrhosis

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World Journal of Gastroenterology 2021年第26期27卷 3984-4003页

作者： Kapil Gupta abhishek bhurwal Cindy Law Scott Ventre Carlos D Minacapelli Savan Kabaria You Li Christopher Tait Carolyn Catalano Vinod K Rustgi Division of Gastroenterology and Hepatology Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNJ 08901United States Department of Internal Medicine Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNJ 08901United States

Acute kidney injury(AKI)in cirrhosis,including hepatorenal syndrome(HRS),is a common and serious complication in cirrhotic patients,leading to significant morbidity and *** is separated into two categories,non-HRS AKI and *** most recent definition and diagnostic criteria of AKI in cirrhosis and HRS have helped diagnose and prognosticate the *** pathophysiology behind non-HRS-AKI and HRS is more complicated than once theorized and involves more processes than just splanchnic *** common biomarkers clinicians use to assess kidney injury have significant limitations in cirrhosis patients;novel biomarkers being studied have shown promise but require further studies in clinical settings and animal *** overall management of non-HRS AKI and HRS-AKI requires a systematic *** pharmacological treatments have shown mortality benefit,the ideal HRS treatment option is liver transplantation with or without simultaneous kidney *** research is required to optimize pharmacologic and nonpharmacologic approaches to *** article reviews the current guidelines and recommendations of AKI in cirrhosis.

关键词： Acute kidney injury Hepatorenal syndrome Liver cirrhosis Treatment Biomarkers Prognosis

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